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XELOX和FOLFOX方案治疗晚期胃癌的随机对照研究目的比较XELOX方案和FOLFOX方案对晚期胃癌的临床疗效和毒副反应。
方法110例晚期胃癌患者随机分为XELOX组和FOLFOX组。
所有病例治疗三周期以上,按WHO标准评价并比较客观疗效和毒副反应。
结果XELOX组总有效率53.6%,TTP 6.0个月;FOLFOX组总有效率48.1%,TTP 5.8个月;两组总有效率差异无统计学意义。
XELOX组手足综合征的发生率明显高于FOLFOX组(P ＜0.05),血小板下降也高于FOLFOX组,白细胞下降和恶心呕吐的发生率低于FOLFOX组,但均无统计学意义(P>0.05)。
结论XELOX方案和FOLFOX方案治疗晚期胃癌疗效相当,且毒副反应小,耐受性好。
[Abstract] ObjectiveTo evaluate the efficacy and toxicity of XELOX versus FOLFOX in the treatment of advanced gastric cancer. Methods110 cases with advanced gastric cancer were enrolled into this study. 56 patients and 54 patients were randomly divided into XELOX group and FOLFOX group respectively. All patients received three cycles of chemotherapy at least. The efficacy and toxicity were evaluated according to WHO standard. ResultsThe overall effective rate and time to disease progression(TTP) in XELOX group were 53.6% and 6.0 months,and in FOLFOX group were 48.1%and 5.8 months respectively. It was no significant difference between two groups. The incidence of hand-foot syndrome of XELOX was obviously higher than that of FOLFOX(P＜0.05). The other side effects such as thrombocytopenia,nausea and vomiting,had no statistical difference between two groups(P>0.05). ConclusionBoth of the two regimens were effective and well tolerated in treatment of advanced gastric cancer with slight side efects. But XELOX regimen may be more comfortable to the old patients.[Key words]Advanced gastric cancer; Oxaliplatin; Capecitabine; 5-flurouracil胃癌是我国常见的恶性肿瘤,至少80%以上的胃癌患者就诊时已为晚期[1],手术切除已不可能。
改良FOLFOX6新辅助化疗与术后化疗治疗进展期胃癌的临床效果比较目的比較改良FOLFOX6新辅助化疗与术后化疗治疗进展期胃癌的临床效果及不良反应。
方法选择2009年3月～2010年6月瑞安市人民医院60例经组织学证实的局部进展期或转移性胃癌患者，分为改良FOLFOX6新辅助化疗组（术前组）、改良FOLFOX6术后辅助化疗组（术后组），化疗4周后进行疗效评价，观察两组临床效果、疾病进展时间、生存时间和不良反应。
结果术前组总有效率及肿瘤控制率（50.0%、76.7%）均高于术后组（43.3%、70.0%），差异有统计学意义（χ2= 5.90，5.88，均P 70分。
术后组30例，其中男20例，女10例；年龄41～79岁中位年龄56.18岁；中分化腺癌12例，低分化腺癌10例，印戒细胞癌8例；临床分期：Ⅱ期患者10例，Ⅲ期患者9例，Ⅳ期患者11例，KPS评分均>70分。
两组患者在年龄、性别、病程分期、病理类型指标等方面差异无统计学意义（P > 0.05），具有可比性。
1.2 纳入标准①所有病例均经胃镜活检，病理学证实为胃腺癌；②cTNM分期为T3～4NanyM（依据2009年UICC TNM分期标准：主要依据腹部CT，并结合胃镜、B超等，必要时超声内镜，MRI、PET/CT、上消化道造影等）；③患者年龄18～80岁；④Karnofsky评分≥70分；⑤预计生存时间≥3个月；⑥既往无根治或姑息手术、放化疗史等的初治患者；⑦主要器官功能正常，无化疗禁忌证；⑧患者签署化疗知情同意书。
1.3 治疗方法1.3.1 术前组采用改良FOLFOX6方案新辅助化疗组。
改良FOLFOX6化疗方案如下：奥沙利铂130 mg/m2，静脉滴入>2 h，第1天；亚叶酸钙400 mg/m2静脉滴入，第1天；5-氟尿嘧啶400 mg/m2，静脉滴入<2 h，第1天；随后予5-氟尿嘧啶2.4 g/m2，持续静脉滴入46 h。
XELOX与FOLFOX6方案一线治疗晚期结直肠癌的近期疗效及不良反应比较目的：比较分析XELOX与FOLFOX6一线治疗晚期结直肠癌的近期疗效以及不良反应情况。
方法：选取我院收治的40例晚期结直肠癌患者为研究对象，将其随机分为A组和B组，每组各20例，A组患者采用XELOX（卡培他滨联合奥沙利铂）方案治疗，B组患者采FOLFOX6（亚叶酸钙（CF）、5-氟尿嘧啶（5-FU）联合奥沙利铂）方案治疗，对比两组患者的疗效和不良反应。
结果：A 组患者治疗有效率为50.0%，B组为45.0%，两组差异不具显著性（P>0.05）。
A 组患者中性粒细胞减少、神经毒性、血小板减少发生率明显低于B组（P＜0.05），而手足综合征的发生率则明显高于B组（P＜0.05）。
结论：XELOX和FOLFOX6方案治疗晚期结直肠癌的近期疗效方面无显著差异，而前者比后者用药更为方便，且不良反应情况整体优于后者，有更高的临床应用价值。
标签：晚期结直肠癌；卡培他滨；奥沙利铂；Abstract ：objective：comparative analysis of XELOX and FOLFOX6 first-line treatment of advanced colorectal cancer in the near future curative effect and adverse reactions. Methods：40 cases of patients with advanced colorectal cancer to select our hospital as the research object，its were randomly divided into group A and group B，20 cases in each group，A group of patients using XELOX （capecitabine in combination with oxaliplatin into）solution treatment，the patients in group B FOLFOX6 （calcium leucovorin （CF），5 - fluorouracil （5 FU）in combination with oxaliplatin into）solution treatment，compared two groups of curative effect and adverse reaction of patients. Results：the patients of group A treatment effective rate of 50.0%，B group was 45.0%，has no significant difference in the two groups （P > 0.05）. A group of patients with neutropenia，neurotoxicity，the incidence of thrombocytopenia was lower than that in group B （P 60分，且预计生存期均大于3个月。
Xelox与mFOLFOX-6方案治疗晚期结直肠癌的药物经济学比较作者：王巍林秀强胡斌赵莹徐绮华林奔招丽蓉来源：《上海医药》2011年第12期摘要目的：通过前瞻性研究，观察比较Xelox与mFOLFOX-6方案治疗晚期结直肠癌的疗效、毒副作用及药物经济学指标，为临床医生选择药物提供参考。
方法：初治的晚期结直肠癌患者分两组进行姑息化疗：Xelox组(奥沙利铂联合卡培他滨3周方案)和mFOLFOX-6组（奥沙利铂联合亚叶酸钙、氟尿嘧啶2周方案），密切随访，统计疗效、毒性及药物经济学数据并进行统计学分析。
结果：共84例患者完成既定治疗方案，其中Xelox组有效率47.4%，mFOLFOX-6组有效率52.2%，差别无统计学意义（P＞0.05）；mFOLFOX-6组粒细胞减少和神经毒性发生率较高，Xelox组腹泻和手足综合征发生率较高，差异有统计学意义（P＜0.05）。
两组平均住院总费用相似；Xelox组平均住院7.3次、住院55.0 d，显著低于mFOLFOX-6组的9.3次和88.3 d（P＜0.05）。
但Xelox组药品所占费用比例65.6%，高于mFOLFOX-6组的50.2%（P＜0.05）。
结论：两个方案的疗效相似，毒性不同。
与mFOLFOX-6方案相比，Xelox方案住院总费用与之相似，药品费用比例较高，但住院次数少，住院天数较短，临床实践中医生可以根据实际情况选择不同化疗方案。
关键词结直肠癌卡培他滨氟尿嘧啶药物经济学中图分类号：R956；R979.1 文献标识码：B 文章编号：1006-1533(2011)12-0594-04Clinical and drug economic comparison betweenXelox and mFOLFOX-6 in treatment of metastatic colorectal cancerWANG Wei，LIN Xiu-qiang，HU Bin，ZHAO Ying，XU Qi-hua，Lin Ben，ZHAO Li-rong（Department of Medical Oncology，the First People’ s Hospital of Foshan City，Foshan，528000）ABSTRACT Objective: A prospective study was performed to evaluate the clinical efficacy，side effects and costs of two different regimens (mFOLFOX-6，Xelox) in treatment of metastatic colorectal cancer (MCRC). Methods: Chemotherapy-naive patients with MCRC were assigned to receive Xelox （oxaliplatin and capecitabine） or mFOLFOX-6（oxaliplatin，leucovorin and 5-Fu）. The patients were followed-up intensively. Clinical and drug economic data were collected and analyzed statistically. Results: A total of 84 patients (Xelox n = 38；mFOLFOX-6 n = 46) completedthe planned schedules. Obejective response rates（ORR） were 47.4% and 52.2% with Xelox and mFOLFOX-6，respectively （P＞0.05）. Xelox patients had significantly more hand-foot syndrome and diarrhea，but significantly less neutropenia and neuropathy than mFOLFOX-6 patients. The mean chemotherapy costs were similar between the two regimens. The mean hospitalization times and days were significantly lower in Xelox patients：7.3 vs 9.3 times and 55.0 vs 88.3 days，respectively （P＜0.05）. The rate of drug cost of Xelox was 65.6% and statistically higher than 50.2% of mFOLFOX-6（P＜0.05）. Conclusion: Xelox is similar in terms of efficacy to mFOLFOX-6 in the chemotherapy of MCRC with different toxicity profile. The patients received Xelox had less hospitalization time and higher drug cost. Oncologists could choose proper chemotherapy regimen by patients’ individual situation.KEY WORDS metastatic colorectal cancer；capecitabine；fluorouracil；drug economics目前，氟代嘧啶类药物是治疗结直肠癌的基本用药。
世界最新医学信息文摘 2021年 第21卷 第2期157投稿邮箱：zuixinyixue@·临床研究·成人结直肠癌mFOLFOX6与XELOX 化疗方案对疗效对比分析顾文斌（云南昆钢医院 普外科，云南 安宁 650300）0 引言结直肠属于一种恶性肿瘤疾病，目前在全世界范围内的发病率比较高，特别是在我国，患有结直肠癌的患者人数越来越多，而且病死率也越来越高。
结直肠癌在逐渐发展的过程当中很容易转移到肝脏部位，所以在临床上进行结直肠癌肝转移治疗也存在着一定难度[1]。
目前临床治疗结直肠癌肝转移的主要方式为手术，根据相关研究调查表明患有结直肠癌肝转移的患者，在接受手术治疗之后五年的生存率在20%至50%，治疗之后疾病的复发率高达75%。
所以临床上也需要提高对手术治疗之后降低复发率，提高生存率等方面的重视。
根据大量的临床实验表明，通过辅助化疗可以有效地减少肝转移术后复发风险，有利于改善患者的预后效果[2]。
针对处于Ⅱ或Ⅲ期结直肠癌患者来说，有效的术后辅助化疗已经成为了比较常见的治疗方式，其中主要应用的就是铂类联合氟尿嘧啶类药物化疗方案，而奥沙利铂作为一种第三代新型铂类抗癌药物，应用在Ⅱ或Ⅲ期结直肠癌中也具有一定的疗效，因此mFOLFOX6与XELOX 化疗方案在临床上也得到了相应的推广，但是对于两种治疗方案的效果并不明确，本次研究就针对成人结直肠癌mFOLFOX6与XELOX 化疗方案疗效对比进行分析，具体内容如下。
1 资料与方法1.1 临床基础资料。
将我院在2019年01月至2019年12月期间收治的60例成人结直肠癌患者视为本次研究对象，根据随机的方式将患者分成观察组和对照组，每组患者30例，分别接受不同的化疗方案。
其中观察组中有男16例，女14例，年龄31-77岁，平均（40.31±1.22）岁，对照组中有男17例，女13例，年龄28-75岁，平均（40.25±1.21）岁，两组患者在年龄方面差异无统计学意义，P>0.05。
Ⅱ、Ⅲ期结肠癌患者辅助化疗XELOX方案、FOLFOX方案的临床疗效、不良反应及生活质量对比摘要：目的比?^辅助化疗XELOX方案、FOLFOX 方案对Ⅱ、Ⅲ期结肠癌患者的临床疗效、不良反应及生活质量的差异。
方法收集2009年1月～2012年1月解放军第二五四医院普通外科收治的行根治性手术切除的171例结肠癌患者的临床资料，按数字随机分为两组，90例患者术后接受XELOX化疗方案，81例接受FOLFOX化疗方案。
比较两组患者的无病生存期、5年生存率、不良反应发生及生存质量的差异。
结果XELOX组34例（37.78%）出现病情进展，FOLFOX组28例（34.57%）出现病情进展。
XELOX组、FOLFOX组的3年无病生存率对比，差异无统计学意义（P>0.05）。
XELOX组死亡21例（23.33%）。
FOLFOX组死亡19例（23.46%）。
Log-rank检验结果显示，两组患者5年生存率对比，差异无统计学意义（P>0.05）。
两组患者恶性呕吐、高胆红血症的不良反应发生率，差异无统计学意义（P>0.05）。
神经毒性、腹泻、白细胞减少、粒细胞减少、血小板减少、口腔黏膜炎的发生率，FOLFOX组高于XELOX 组，差异有统计学意义（P0.05）。
结论对Ⅱ、Ⅲ期结肠癌患者而言，XELOX方案与FOLFOX方案在提高术后无病生存期、5年生存率及生活质量方面无明显差异。
但XELOX方案不良反应更少，患者的依从性与耐受性更好。
关键词：结肠癌；卡培他滨；奥沙利铂；氟尿嘧啶中图分类号：R735.3 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.13.020文章编号：1006-1959（2018）13-0068-05Abstract：Objective To compare the clinical efficacy，adverse reactions and quality of life of patients with stage II and III colon cancer by XELOX and FOLFOX.Methods The clinical data of 171 patients with colon cancer who underwent radical surgery for general surgery in the 254th Hospital of Chinese People's Liberation Army from January 2009 to January 2012 were collected.They were randomly divided into two groups according to the number.90 patients received XELOX chemotherapy after operation and 81 patients received FOLFOX chemotherapy.The disease-free survival，5-year survival rate，adverse reaction occurrence and quality of life were compared between the two groups.Results In the XELOX group，34 patients（37.78%）developed disease progression，and 28 patients （34.57%）in the FOLFOX group developed disease progression.There was no significant difference in the 3-year disease-free survival rate between the XELOX group and the FOLFOX group（P>0.05）.21 patients（23.33%）died in theXELOX group.19 patients （23.46%）died in the FOLFOX group.Log-rank test results showed that there was no significant difference in the 5-year survival rate between the two groups （P>0.05）.There was no significant difference in the incidence of adverse reactions between malignant vomiting and hyperbilirubinemia between the two groups（P>0.05）.The incidence of neurotoxicity，diarrhea，leukopenia，neutropenia，thrombocytopenia，and oral mucositis was higher in the FOLFOX group than in the XELOX group，the difference was statistically significant（P0.05）.Conclusion For patients with stage II and III colon cancer，there is no significant difference between the XELOX regimen and the FOLFOX regimen in improving postoperative disease-free survival，5-year survival，and quality of life.However，the XELOX regimen has fewer side effects and better patient compliance and tolerance. Key words：Colon cancer；Capecitabine；Oxaliplatin；Fluorouracil 结肠癌（colon cancer）是消化道常见的恶性肿瘤，随着我国经济社会的发展和生活水平的提高，人们的食物谱发生了很大改变，高油脂、高蛋白、低纤维素的膳食结构也在一定程度上促进了我国结肠癌发病率的增高[1，2]。
XELOX方案与mF0LF0X6方案的剂量强度对结肠癌术后辅助化疗的效果比较！马妮娜！，王婧，赵磊，曹邦伟#（首都医科大学附属北京友谊医院肿瘤中心,北京100050）中图分类号R979.1文献标志码A文章编号1672-2124（2019）07-0782-04DOI10.14009/j.i-/.1672-2124.2019.07.005摘要目的：比较XELOX方案（奥沙利铂+卡培他滨）与ZFOLFOX6方案（奥沙利铂+亚叶酸钙+氟尿喀啶）的剂量强度对结肠癌术后辅助化疗的临床效果"方法：对2010—2014年首都医科大学附属北京友谊医院180例诊断为#期结肠癌的患者资料进行回顾性分析，按照术后辅助化疗方式的不同分为XELOX组（105例）和ZFOLFOX6组（75例），主要终点为剂量强度和毒性，次要终点为无病生存期（disease-free survival,DFS）。
结果：XELOX组中卡培他滨实际用量较其理论标准用量的降低幅度明显大于mFOLFOX6组中氟尿喀啶实际用量较其理论标准用量的降低幅度，差异有统计学意义（!=0.0014）；XELOX组中奥沙利铂实际用量较其理论标准用量的降低幅度明显大于mFOLFOX6组，差异有统计学意义（!=0.0001）o mFOLFOX6组中治疗延迟＞1个周期的患者数为XELOX组的2倍，两者的差异有统计学意义（！二0.039）。
mFOLFOX6组患者化疗相关毒性反应更为常见"平均随访40个月，两组患者DFS的差异无统计学意义（!=0.598）O结论：在结肠癌辅助化疗中，mFOLFOX6方案的毒性会较XELOX 方案相对增加，而XELOX方案剂量强度的相对减少对患者的DFS没有影响"关键词剂量强度；辅助化疗；结直肠癌Comparison of Effects between Different Dose Intensity of XELOX Regimen and mFOLFOX6 Regimen in Postoperative AdjuvanS Chemotherapy of Colon Cancer!MA Nina,WANG Jing,ZHAO Lei,CAO Bangwei(Cancee Centee,Beijing Friendship Hospital Affiliated ta Capital Medical University,Beijing100050,China)ABSTRACT OBJECTIVE:To compare the clinicci effecae between diff—t dose intensity of XELOX egimen (oxaliplativ+capecitabine)and mFOLFOX6vgiaen(oxaliplatin+leucoverin+fluorouracii)in postoperative adjuvant chemotherapy of colon cancee.METHODS:180patients diaanosed with staae皿colon cancer in Beijing Friendship Hospitai Affiliated ta Capita*Medical University from2010ta2014were retrospectiveiy analyzed and divided inta XELOX gaoup(105cases)and mFOLFOX6gaoup(75cases)accoading ao di r eaenaposaopeaaaiee adiueana chemothevpy veimens.The primaro endpoint was dose intensity and toxicity,the secondare endpoint was diseese-free surviel(DFS).RESULTS:The decreesing amplitud betaeen actual dosage ta W c etical dosdge of capecitabine in XELOX group was significantiy gedter than that of the fluorouracii in mFOLFOX6group,with statistical i y significant dit——co(!=0.0014)；the decreesing amplitud between actuai dosaae to theoreticai dosage of oxaliplativ in XELOX group was sienificantiy evcWt than that of the mFOLFOX6group,with statistical i y significant dferenco(!= 0.0001)i The numbee of patients with a delay of oveo1treatwent course ip the mFOLFOX6group was twico as the XELOX group,with statisticaliy significant dmerenco(!二0.039).C h emotherapy-r elated toxicity is more common in mFOLFOX6group<The averaae follow-up period was40months,there was no stwisticai signincanco ip deferenco ip DFS between two groups(!=0.598).CONCLUSIONS:In the ddjuent chemotherapy of colon canar,the toxicity of mFOLFOX6recimen is relativeiy higher than that of XELOX recimen,and the relative decreese in the dose intensity of XELOX regimen has no ef^eci on patient s DFS.KEYWORDS Dose intensity;Adjuent chemotherapy;Colon cancer虽然靶向治疗和免疫治疗是当今研究的热点，但是化疗!基金项目:北京市自然科学基金（=.7092103）!副主任医师’研究方向：消化系统肿瘤的临床诊治’E-maii: manina1970@#通信作者:主任医师’研究方向：消化系统肿瘤的基础和临床研究。
